根治性前列腺切除术联合新辅助内分泌治疗对前列腺癌患者临床疗效分析  

Clinical efficacy of prostatectomy combined with neoadjuvant endocrine therapy

作　　者：袁海建 储开云 徐卫东 YUAN Hai-jian;CHU Kai-yun;XU Wei-dong(Department of Urology,Hai'an People's Hospital,Hai'an,Jiangsu 226600,China)

机构地区：[1]海安市人民医院泌尿外科,江苏海安226600

出　　处：《中华男科学杂志》2025年第4期323-327,共5页National Journal of Andrology

基　　金：江苏省自然科学基金面上项目(BK20221220);南通市科技计划项目(GJZ17068)。

摘　　要：目的:探讨根治性前列腺切除术联合新辅助内分泌治疗对前列腺癌患者临床疗效分析。方法:研究纳入2019年1月至2023年12月海安市人民医院收治的147例前列腺癌患者,采用随机数字表法分组,平均分为3组,每组49例,对照组1予以根治性前列腺切除术治疗,对照组2接受内分泌治疗,观察组予以根治性前列腺切除术联合新辅助内分泌治疗,比较3组临床指标、治疗前后的前列腺症状改善[国际前列腺症状评分(IPSS)]、免疫功能(CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+))、血清水平[PSA、血管内皮生长因子(VEGF)]、并发症发生情况。术后进行为期1年的随访,记录复发情况。结果:治疗后,观察组手术时间、淋巴结清扫时间较对照组1短,术中出血量和病理切缘阳性率更低;观察组IPSS评分较对照组1和对照组2低;观察组CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)较另外两组升高;在PSA、VEGF水平上,观察组更低;在并发症发生率上,观察组较对照组1和对照组2低,且观察组术后1年的复发率低于另外两组。以上比较,差异均有统计学意义(P<0.05)。结论:根治性前列腺切除术联合新辅助内分泌治疗较单独根治术可显著改善前列腺癌患者的临床指标、免疫功能、降低PSA和VEGF水平,减少术后并发症,提高治疗效果。Objective:To investigate the clinical effect of prostatectomy combined with neoadjuvant endocrine therapy.Methods:A total of 147 prostate cancer patients who were treated at the Hai'an People's Hospital from January 2019 to December 2023 were enrolled in the study.The patients were randomly divided into three groups using a random number table,with 49 cases in each group.The patients in control group 1 were treated with radical prostatectomy alone.Endocrine therapy was performed in control group 2.And the patients in observation group received radical prostatectomy combined with neoadjuvant endocrine therapy.Clinical indicators,improvement of prostate symptoms(measured by the IPSS),immune function(CD3~+,CD4~+,CD4~+/CD8~+ ratio),serum levels(PSA and vascular endothelial growth factor [VEGF]),and complications were compared among the three groups.A one-year postoperative follow-up was conducted to monitor recurrence.Results:After treatment,the patients in observation group had shorter operative time and lymph node dissection time,less intraoperative blood loss,and lower rate of positive surgical margins compared to control group 1.The IPSS score in the observation group was significantly lower than that in control group 1 and control group 2.The levels of CD3~+,CD4~+,and the CD4~+/CD8~+ ratio were higher in the observation group compared to the other two groups.The serum levels of PSA and VEGF were lower in the observation group.The incidence of complications in observation group was lower compared to both control groups.And the recurrence rate after one year was lower in the observation group than that in the other two groups.All differences were statistically significant(P<0.05).Conclusion:The clinical indicators,immune function,levels of PSA and VEGF as well as postoperative complications can be improved through radical prostatectomy combined with neoadjuvant endocrine therapy.

关 键 词：根治性前列腺切除术 新辅助内分泌治疗 前列腺癌 症状改善 免疫功能 

分 类 号：R737.25[医药卫生—肿瘤]